Dengue Virus Infection Triggering Thrombotic Thrombocytopenic Purpura in Pregnancy

Surendran Deepanjali, Raghuramulu R. Naik, Sharada M, Sivamani Kalaimani, Tamilarasu Kadhiravan

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15 Citations (Scopus)


We report a case of thrombotic thrombocytopenic purpura (TTP) that immediately followed symptomatic dengue virus infection in a pregnant lady. The patient developed dengue fever at 16 weeks of gestation, resulting in spontaneous abortion. Subsequently, fever reappeared with persistent thrombocytopenia and jaundice. Investigations revealed microangiopathic hemolysis; there was no evidence of disseminated intravascular coagulation. The TTP episode resolved after six cycles of therapeutic plasma exchange with fresh-frozen plasma. An ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 motif 13 repeats) activity assay, done during convalescence, showed normal activity. The patient had an uneventful second pregnancy and has remained free of TTP recurrence for more than 2 years
now. We review the pathophysiological basis of TTP in dengue infection, and suggest that jaundice with disproportionate elevation of serum aspartate aminotransferase level in a patient with dengue should arouse the suspicion of TTP.
Original languageEnglish
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number5
Publication statusPublished - 2015


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